Biomedical subjects
J Weingarten
Publications and source records attributed to J Weingarten.
[A comparison of the course of anesthesia using a bolus application of propofol, methohexital or etomidate as hypnotics and alfentanil analgesia].
The suitability of the analgesic-hypnotic combination alfentanil-propofol in nitrous oxide-oxygen IPPB for short-term and outpatient anesthesia was studied in 50 patients of ASA risk groups I and II. This study appeared pertinent since the two substances have the shortest half-lives of their respective classes of medication. For comparison, two groups of similar size were treated with the well-established combinations alfentanil-methohexital and alfentanil-etomidate. During the entire intra- and postoperative periods the circulatory parameters were frequently monitored as was the continuous recording of the compressed spectral array in the EEG. Thirty minutes after extubation three modified tests of recovery were carried out that were compared to the preoperative results. For a subjective evaluation, a multiple choice questionnaire was answered by each patient after the recovery tests. The mean duration of anaesthesia in all three groups was 1 h. All three combinations were found to be agreeable to the patients with the best results in the propofol group. These patients also showed the most rapid recovery; consequently, the combination of alfentanil and propofol would appear to be especially suitable for outpatients. For the induction of anesthesia alfentanil was administered in a dosage of 30 micrograms/kg body weight in combination with propofol 1.5 mg/kg, methohexital 1.0 mg/kg or etomidate 0.2 mg/kg. For anesthesia maintenance the following mean dosages were found to be suitable: Alfentanil 1 microgram/kg/min, propofol 46 micrograms/kg/min, methohexital 24 micrograms/kg/min, and etomidate 4 micrograms/kg/min.(ABSTRACT TRUNCATED AT 250 WORDS)
Transitional cell neoplasms of the urinary bladder. Can biologic potential be predicted from histologic grading?
The concept that most transitional cell neoplasms of the urinary bladder exist as either nonaggressive lesions of low cytologic grade or aggressive anaplastic cancers is gradually gaining acceptance. The extent to which the biological potential of these neoplasms is revealed in their pathologic features is the subject of this article. Using guidelines developed in experimental models, a series of 400 transitional cell neoplasms selected for long-term follow-up were classified into the WHO system. The results indicate that (1) almost all transitional cell tumors can be grouped into low and high grades at initial presentation; (2) the low grade lesions (usually designated transitional cell carcinoma, Grade I) are benign and should be called papillomas rather than carcinomas; (3) the risk of progression is not a function of the number of recurrences for these noninvasive, low-grade, papillary tumors; (4) the high-grade neoplasms are aggressive whether papillary or nodular and account for greater than 93% of tumor-related deaths; (5) patients with high-grade lesions have a reduced life expectancy even if progression does not occur; (6) depth of invasion and growth pattern are limited as predictive factors compared with histologic grade; (7) histologic grading of the initial tumor tissue can be highly predictive of outcome.
Nasal polyposis with invasion into the orbit.
Proptosis of the left eye developed in a 51-year-old man with a long history of nasal polyposis. Displacement of the orbit was associated with a palpable mass superior and lateral to the orbit. Roentgenographic studies, including a sinus series, computed tomographic scan, and axial tomogram of the left orbit, showed a soft-tissue mass in the superolateral compartment of the left orbit and left frontal sinus, suggesting a mucocele. The surgical and pathological findings disclosed polyps of the frontal sinus invading the orbit through a dehiscence of the lateral orbital roof. To our knowledge, this is the first reported case of invasion of frontal sinus polyp into the orbit through the superolateral wall.
External radioflux detection: noninvasive measurement of protein leakage in assessing lung microvascular injury.
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Teflon embolization to pulmonary arteries.
A previously unreported complication of cardiac surgery, embolization to the lungs from Teflon pledgets, is presented. The pathological changes found in the pulmonary arteries postmortem are described and their possible clinical significance is discussed. Properties inherent in Teflon are implication in the origin of the embolization.
Can confidential patient information be kept private in high-tech medicine?
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Cytologic and histologic findings in a case of tracheobronchial papillomatosis.
tracheobronchial papillomatosis is a rare pathologic entity that should be considered in the differential diagnosis of bronchogenic squamous cell carcinoma. Although well differentiated histologically, papillomatosis has an aggressive pattern of growth, producing multiple and extensive endobronchial lesions that grossly simulate advanced malignancy. Cytologic examination shows atypical but not anaplastic features. These include unique, regular-layered arrangements of keratin resembling keratotic plugs, which may be specific for this tumor. Malignant transformation has been reported.